The present invention relates to systems and methods for pedicle screw insertion into a spine, and in particular, to navigational probes for creating a trajectory in a pedicle for subsequent pedicle screw insertion.
Various systems have been developed to aid surgeons in translating and tracking the position of surgical tools or probes during surgical procedures, such as the system described in U.S. Pat. No. 7,166,114 (“the '114 patent”), the entire disclosure of which is hereby incorporated by reference herein. Such systems have been useful in performing neurological related procedures such as procedures for insertion of pedicle screw into the spines of patients. A navigable jamshidi and certain custom probe designs have been used to perform such steps of these procedures. However, these devices frequently lose positions registered by the navigation tracking system that interfaces with the devices, often due to unreliable attachment of an adapter connecting the navigation tracking system to the devices which leads to undesirable rotational movement of the navigation tracking system. As such, these probe devices require calibration of both position and orientation with respect to the tracking systems with which they are used. Furthermore, custom probe designs often have a stylus tip that is difficult to remove from bone upon insertion and, moreover, jamshidis have a relatively small cannula diameter which makes them prone to permanent bending and lodging in the bone when used with navigable probe devices.
Other systems having navigable disposable needles that may be used with dedicated, often permanently attached tracking systems and those having rigid cannulated probes or jamshidis, require separate instruments to perform various steps of surgical procedures in which these systems are used. For instance, such systems may require a slim dilator to initiate uniform expansion of an incision prior to using another larger dilator. When calibrating a navigable probe device having either an adapter for attaching or when permanently attaching a navigation tracking system to a probe, separate calibration of additional navigable instruments is required to be used during the surgical procedure.
Thus, there is a need for a navigable probe that can be used to perform multiple surgical steps and that is modular to allow for separation of a handle from any of a stylus and a cannula. There is a further need for a navigable probe having a fixed portion relative to a tracking system used therewith which maintains the registry after replacement of one or both of the stylus and cannula without the need to recalibrate in order to prevent unreliable registry of probe positions.